California EMS Schools.

EMTs are the Heart and Soul of Emergency Medicine

Today, the Emergency Medical System (EMS) across the United States is a sophisticated and highly regulated segment of the health system. The move towards organizing a national emergency medicine plan began with the publication of a white paper issued in 1966 by the National Academy of Sciences entitled, "Accidental Death & Disability: The Neglected Disease of Modern Society". In 1966, the Highway Safety Act authorized states to implement, improve, and refine pre-hospital care in the United States, defining standards of care from ambulance requirements, to the training of EMTsand paramedics.

The EMS is still evolving today as newer and more advanced equipment is developed, the 911 communications system is improved, and emergency medical personnel are trained and certified in more complicated and advanced care techniques.

What Happens When a Call is Received by a 911 Communications Center?

The 911 operator determines the location of the emergencyand sends out an alert to the appropriate emergency response team. The type of team varies from community to community, and can be a volunteer fire and rescue service, a police-fire department, a paid ambulance service, or a hospital emergency response team.

As the alert goes out to the response team, the operator asks pertinent questions of the caller in order to determine the type of emergency that exists. This information is then relayed to the response team via two-way radio communications.

At the response team headquarters, personnel, either paid or volunteer, receive the 911 alert and man the appropriate vehicles. In the case of an automobile accident, an ambulance will be sent along with a fire truck due to the possibility of fire or rescue mission. For a possible heart attack, only an ambulance or first responder vehicle will be sent. The procedures vary from team to team, and may be dependent upon decisions of personnel present at the time of the emergency call.

Communications between the 911 center and the emergency team remain open, and the team will have radio contact with the nearest hospital emergency room or trauma center. Physicians in the emergency center will give medical directives to the paramedics or EMTs on the scene, and will prepare emergency department staff for the incoming emergency.

Once the scene is contained, the victim is given a primary assessment of injuries and symptoms. The first and most important determinations involve the "ABCs" of patient assessment: airway, breathing, and circulation. If the patient isn't breathing, steps are then taken to open the airway and perhaps perform CPR or defibrillation if both breathing and circulation are absent.

Training and Certification Standards for EMTs

Standards for emergency medical technicians vary from state to state, but most require that stringent standards are met. Training classes often are held at community colleges, and involve learning medical terms, anatomy, symptoms, and procedures. Knowledge and practice of techniques like CPR, splinting and bandaging are also part of the training.

In order to become certified by the Department of Health (in most states), the EMT trainee must pass a written test and a practical test. Certifications must be periodically updated with refresher classes and tests.